Madison, Wisconsin - It's 5:15 on a Friday evening, and your fellow commuters don't seem to realize you have places to be.

You promised to meet up with friends by 5:00, but the rush-hour highway is jammed and the jerk in the car a sliver ahead of you just cut you off without looking in his blind spot.

You are not happy.

In fact, you're furious, and no one would blame you if you leaned into your horn and screamed out an obscenity or two.

Two problems: That kind of behavior is inconsiderate. But it's also unhealthy, particularly for your heart.

"Stress is a significant contributing factor to the occurrence of cardiovascular disease," says Shilagh Mirgain, PhD, a UW Health psychologist who works extensively in the organization's Preventive Cardiology group. When pinpointing factors that contribute to cardiovascular disease, Dr. Mirgain says, "we often think of exercise, nutrition and family history, but stress is equally important and sometimes underemphasized."

Recognizing the relationship between stress and cardiovascular disease, Dr. Mirgain is offering a six-week education and support group. "Skills for a Happy Heart," which runs from November 7-December 12, will teach participants how to manage stress at home and at work and make healthy adjustments to reduce risk for further cardiac disease.

"This group looks at what stress is and how you can identify stress, and will give you a variety of cognitive-behavioral tools to better manage it" Dr. Mirgain says.

The link between heart disease and stress was reinforced by a study published in the January edition of Archives of Internal Medicine. The study's authors divided 362 men and women who had been hospitalized for a heart event into two groups with respective care regimens that differed in one way. The hypothesis group received 40 hours of stress management training in the year following discharge from the hospital.

The results of the study reinforce Dr. Mirgain's assertion. People in the hypothesis group experienced 41 percent fewer recurrent heart events than those in the control group. In other words, learning how to minimize the negative impact of stress was beneficial to their hearts and overall health.

Managing stress, Dr. Mirgain says, requires a mind-body shift. Physiologically, the body reacts naturally to stress by taxing the sympathetic nervous system. It pumps adrenaline, releases the hormone cortisol, produces more cholesterol and increases blood pressure. This "fight-or-flight" response serves an evolutionary purpose by physically preparing us to defend ourselves or flee when confronted by danger, but it's also harmful.

"Stress definitely affects the heart. When faced with stressful situations, the heart has to work harder, to beat faster, and blood vessels constrict to get more blood to the core of the body instead of the extremities," Dr. Mirgain says. This increased workload "can be a contributing factor to heart disease, hardening of the arteries and even heart attacks."

Dr. Mirgain's sessions, then, will focus on ways to mitigate the sympathetic nervous system in part by adjusting how we think about stress. A more balanced, tranquil perspective leads to a less stress-producing physiological reaction.

Using the inherent frustration of the traffic jam as an example, Dr. Mirgain encourages patience and calm rather than irritability and rage.

"We can spend our time feeling frustrated, which will cause us to have that stress response in our bodies, or we can focus on something more pleasant or neutral, and lower the sympathetic activation in our bodies," she says. "The same stressor happens. We just think about it differently."

The "Skills for a Happy Heart" group will also reduce the impact of stress on the cardiovascular system by teaching relaxation skills that improve heart rate variability. When we're relaxed, the interval between heart beats varies. When we're angry or stressed, the heart beats have less variability.

"We're going to change the pattern of our heart rates directly," Dr. Mirgain says. "When we have that variability, we have more balance in our nervous systems."

Maliyaka John says another lesson from the group was most beneficial to him. The 62-year-old University of Wisconsin systems managing director enrolled this past summer with the encouragement of his cardiologist, who told him he was at high risk for heart disease because of a daunting family history.

In the group Mr. John learned how to do something most of us take for granted. He learned how to breathe.

"Most of the time people breathe from the upper part of their chest," Mr. John says, and in doing so, receive less oxygen to the lungs. Intentionally involving the diaphragm in deep breathing increases the oxygen intake, which in turn keeps the body relaxed and limits stress.

"When we are breathing in a regular, slow pattern through our diaphragm," Dr. Mirgain says, "we have more heart rate variability and there is better balance in the autonomic nervous system's influence on the heart."

Mr. John now devotes 20 minutes each day to breathing that emphasizes the diaphragm and believes the exercises have allowed him to achieve a physical and mental balance that is easy on his heart.

"You can feel the difference," he says. "Air is taken into lower parts of the lungs and there's a calming effect. Most importantly, when you feel anxious, you can go back to deep breathing for a few seconds, and it's very helpful."

Stress may be inevitable, but our response to it is far from ordained. And, as "Skills for a Happy Heart" teaches, that response can mean the difference between a healthy heart and one more vulnerable to cardiac disease.

"We're going to get stressed," Dr. Mirgain says. "It's how we think about and behave in the context of that stress that makes the difference in keeping our hearts healthy."